As rising chronic disease trends are driven, in part, by exposures to harmful chemicals, pollutants, and plastics, a team of more than 30 environmental health experts led by scientists at University of California, San Francisco (UCSF) developed the first decision-making framework for environmental health that prioritizes prevention rather than continuing to allow environmental harms that make people sick.
The new research tool, published today in Environmental Sciences & Technology, is designed to improve regulatory decision-making and help scientists and policymakers consider important factors beyond health effects of exposure to pollutants to better address inequitable community impacts. The framework is built on clinical decision-making methods that enable decisions even when health information is uncertain, critical as most environmental exposures are already happening.
“Ongoing and emerging environmental exposures such as chemical pollution, climate change, and natural resource extraction pose major health risks to populations,” the scientists write. “The World Health Organization (WHO) estimates that two million lives were lost due to chemical exposures in 2019. This estimate is based on methods that do not fully capture all possible risks and is thus likely an underestimate.”
“Current approaches to identifying and preventing widespread population exposures to harmful chemicals have lagged behind chemical production and use,” the scientists say.
“Our system to regulate harmful chemicals is simply not protecting health,” said Tracey J. Woodruff, PhD, MPH, professor and director of the Program on Reproductive Health and the Environment (PRHE) and the EaRTH Center, both at UCSF. “We need new approaches to make sense of evidence when it’s not clear and consider important factors beyond what are currently considered by regulators,” she said.
The new Evidence to Decision-making in Environmental Health Framework considers a “full accounting of health impacts at different levels of exposure, distributions of harms, and considerations of community concerns,” and evaluates that evidence alongside factors such as essentiality of use, health equity, and costs and benefits.
“In most cases, current approaches for considering and quantifying benefits of proposed EPA regulations do not include health effects other than cancer,” said Nicholas Chartres, PhD, of the University of Sydney and co-lead author of the framework and collaborator on the UCSF Program on Reproductive Health and the Environment. “Our new Evidence-to-Decision-Framework for Environmental Health is designed to take us beyond the old way of thinking and capture real-world exposures and prioritize needs of communities most impacted by toxic chemicals and pollutants” he said.
As a case study, the scientists used the new framework to evaluate whether perchloroethylene (PCE), a cancer-causing chemical and neurotoxin used in drycleaning, is essential. Out of 12 categories for consideration, the scientists found only one they in which PCE was deemed essential and developed recommendations to address that use with safer alternatives.
“This is an important tool that, if used correctly, can be a game-changer to better protect people who are exposed to disproportionate amounts of harmful chemicals and pollutants,” said Lauren Zeise, a consultant formerly of CalEPA.
“We’ve been approaching chemical regulation ineffectively,” said Max T. Aung, PhD, MPH, co-lead author while he was at UCSF PRHE and now an assistant professor at University of Southern California (USC). “This new framework will help regulators and researchers ask the right questions and consider factors such as environmental health disparities in decision-making that improve people’s health and lives.”
Development of the Navigation Guide Evidence-to-Decision Framework for Environmental Health.
Co-authors: Nicholas Chartres, Max T. Aung, Susan L. Norris, Courtney Cooper, Lisa A. Bero, Roger Chou, Devon C. Payne-Sturges, Wendy E. Wagner, Jessica W. Reyes, Lisa M. Askie, Daniel A. Axelrad, Deysi Flores Vigo, Jill E. Johnson, Juleen Lam, Keeve E. Nachman, Eva Rehfuess, Rachel Rothschild, Patrice Sutton, Lauren Zeise, Tracey J. Woodruff.
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